Truth has to be taught to a child. The less this is done, the easier it is to inoculate him with religious notions, i. e., of miraculous revelation; otherwise one must be prepared for many questions that are hard to answer.
_29th month._--Sad stories affect him to tears, and he runs away.
Names of animals and plants he remembers often more easily than I do, and informs me. He reasons logically. Lately, when he asked for some foolish thing, I said to him, "Sha'n't I bring the moon for you, too?" _No_, said he, _you can't do that, it is too high up in the clouds_.
_30th to 33d months._--He now often calls himself "Adolph," and then speaks of himself in the third person. He frequently confounds "I" and "you," and does not so consistently use the first person for the second, and the reverse. The transition is very gradually taking place to the correct use of the personal pronoun. Instead of _my mamma_, he repeats often, when he is in an affectionate mood, _your mamma_, _your mamma_.
Some new books are given to him. In the book of beetles there are shown to him the party-colored and the gray, so-called "sad," grave-digger (_necrophorus_). The latter now becomes prominent in his plays. "Why is he called the sad?" I asked the child yesterday. _Ah! because he has no children_, he answered, sorrowfully. Probably he has at some time overheard this sentence, which has no meaning for him, from a grown person.
Adult persons' ways of speaking are thus employed without an understanding of them; pure verbal memory.
In the same way, he retains the names, in his new book, of butterflies (few of them German) better than I do, however crabbed and difficult they may be.
This (pure) memory for mere sounds or tones has become less strong in the now four-year-old boy, who has more to do with ideas and concepts, although his memory in other respects is good.
In the thirty-seventh month he sang, quite correctly, airs he had heard, and he could sing some songs to the piano, if they were frequently repeated with him. His fancy for this soon passed away, and these exercises ceased. On the other hand, he tells stories a great deal and with pleasure. His pronunciation is distinct, the construction of the sentences is mostly correct, apart from errors acquired from his nurse. The confounding of the first and second persons, the "I" and "you,"
or rather his use of the one for the other, has ceased, and the child designates himself by _I_, others by _thou_ and _you_. Men are ordinarily addressed by him with _thou_, as his father and uncle are; women with _you_, as are even his mother and nurse.
This continues for a long time. The boy of four years counts objects, with effort, up to six; numbers remain for a long time merely empty words (pp. 165, 172). In the same way, he has, as yet, but small notion of the order of the days of the week, and mixes up the names of them. To-day, to-morrow, yesterday, have gradually become more intelligible to him.
Notwithstanding the aphoristic character of these extracts from a full and detailed diary of observations, I have thought they ought to be given, because they form a valuable supplement to my observations in the nineteenth chapter, and show particularly how far independent thought may be developed, even in the second and third years, while there is, as yet, small knowledge of language. The differences in mental development between this child and mine are no less worthy of notice than are the agreements. Among the latter is the fact, extremely important in a pedagogical point of view, that, the less we teach the child the simple truth from the beginning, so much the easier it is to inoculate him permanently with religious notions, i. e., of "miraculous revelation."
Fairy tales, ghost-stories, and the like easily make the childish imagination, of itself very active, hypertrophic, and cloud the judgment concerning actual events. Morals and nature offer such an abundance of facts with which we may connect the teaching of language, that it is better to dispense with legends. aesop's fables combine the moral and the natural in a manner unsurpassable. My child tells me one of these fables every morning.
FOOTNOTES:
[D] The vowels have the Continental, not the English, sounds.
[E] Or possibly for the word _drink_, which a child of my acquaintance called _ghing_.--EDITOR.
[F] "The First Three Years of Childhood," edited and translated by Alice M. Christie; published in Chicago, 1885.
B.
NOTES CONCERNING LACKING, DEFECTIVE, AND ARRESTED MENTAL DEVELOPMENT IN THE FIRST YEARS OF LIFE.
The data we have concerning the behavior of children born, living, without head or without brain, and of microcephalous children, as well as of idiots and cretins more advanced in age, are of great interest, as helping us to a knowledge of the dependence of the first psychical processes upon the development of the brain, especially of the cerebral cortex. Unfortunately, these data are scanty and scattered.
Very important, too, for psychogenesis, are reports concerning the physiological condition and activity of children whose mental development has seemed to be stopped for months, or to be made considerably slower, or to be unusually hastened.
Scanty as are the notes I have met with on this matter, after much search, yet I collect and present some of them, in the hope that they will incite to more abundant and more careful observation in the future than has been made up to this time.
A good many data concerning the behavior of cretin children are to be found in the very painstaking book, "Neue Untersuchungen uber den Kretinismus oder die Entartung des Menschen in ihren verschiedenen Graden und Formen" ("New Investigations concerning Cretinism, or Human Deterioration, in its Various Forms and Degrees"), by Maffei and Rosch (two vols, Erlangen, 1844). But, in order that these data should be of value, the observed anomalies and defects of the cerebral functions ought to be capable of being referred to careful morphological investigations of the cretin brain. As the authors give no results of _post-mortem_ examinations, I simply refer to their work here.
I once had the opportunity myself of seeing a hemicephalus, living, who was brought to the clinic of my respected colleague, Prof. B. Schultze, in Jena. The child was of the male sex, and was born on the 1st of July, 1883, at noon, along with a perfectly normal twin sister. The parents are of sound condition. I saw the child for the first time on the 3d of July, at two o'clock. I found all the parts of the body, except the head, like those of ordinary children born at the right time. The head had on it a great red lump like a tumor, and came to an end directly over the eyes, going down abruptly behind; but, even if the tumor were supposed to be covered with skin, there would by no means be the natural arched formation of the cranium of a newly-born child. The face, too, absolutely without forehead, was smaller in comparison than the rest of the body. I found now, in the case of this child, already two days old, a remarkably regular breathing, a very cool skin--in the forenoon a specific warmth of 32 C. had been found--and slight mobility. The eyes remained closed. When I opened them, without violence, the pupil was seen to be immobile. It did not react in the least upon the direct light of the sun on either side. The left eye did not move at all, the right made rare, convulsive, lateral movements. The conjunctiva was very much reddened. The child did not react in the least to pricks of a dull needle tried on all parts of the body, and reacted only very feebly to pinches; not at all to sound-stimuli, but regularly to stronger, prolonged cutaneous stimuli; in particular, the child moved its arms after a slap on the back, just like normal new-born children, and uttered very harsh, feeble tones when its back was rubbed. When I put my finger in its mouth vigorous sucking movements began, which induced me to offer the bottle--this had not yet been done. Some cubic centimetres of milk were vigorously swallowed, and soon afterward the breast of a nurse was taken. While this was going on I could feel quite distinctly with my finger, under the chin, the movements of swallowing. It was easy to establish the further fact that my finger, which I laid in the hollow of the child's hand, was frequently clasped firmly by the little fingers, which had well-developed nails. Not unfrequently, sometimes without previous contact, sometimes after it, the tip of the tongue, and even a larger part of the tongue, was thrust out between the lips, and once, when I held the child erect, he plainly gave a prolonged yawn.
Finally, the fact seemed to me very noteworthy that, after being taken and held erect, sometimes also without any assignable outward occasion, the child inclined its head forward and turned it vigorously both to the right and to the left. When the child had sucked lustily a few times, it opened both eyes about two millimetres wide, and went on with its nursing. An assistant physician saw the child sneeze.
These observations upon a human child, two days old, unquestionably acephalous, i. e., absolutely without cerebrum, but as to the rest of its body not in the least abnormal, prove what I have already advanced (vol. i, p. 203), that the cerebrum takes no part at all in the first movements of the newly-born. In this respect the extremely rare case of an acephalous child, living for some days, supplies the place of an experiment of vivisection. Unfortunately, the child died so early that I could not carry on further observations and experiments. The report of the _post-mortem_ examination will be published by itself.
Every observer of young children knows the great variety in the rapidity of their development, and will agree with me in general that a slow and steady development of the cerebral functions in the first four years, but especially in the first two years, justifies a more favorable prognosis than does a very hasty and unsteady development; but when during that period of time there occurs a complete and prolonged interruption of the mental development, then the danger is always great that the normal course will not be resumed. So much the more instructive, therefore, are the cases in which the children after such a standstill have come back to the normal condition. Four observations of this kind have been published by R. Demme ("19. Bericht uber das Jenner'sche Kinderspital in Bern, 1882," S. 31 bis 52). These are of so great interest in their bearing on psychogenesis, and they confirm in so striking a manner some of the propositions laid down by me in this book, that I should like to print them here word for word, especially as the original does not appear to have found a wide circulation; but that would make my book altogether too large. I confine myself, therefore, to this reference, with the request that further cases of partial or total interruption of mental development during the first year of life, with a later progress in it, may be collected and made public.
It is only in rare cases that microcephalous children can be observed, while living, for any considerable length of time continuously. In this respect a case described by Aeby is particularly instructive.
A microcephalous boy was born of healthy parents--he was their first child--about four weeks too soon. His whole body had something of stiffness and awkwardness. The legs were worse off in this respect than the arms; they showed, as they continued to show up to the time of his death, a tendency to become crossed. The boy was never able to stand or walk. He made attempts to seize striking objects, white or party-colored, but never learned actually to hold anything. The play of feature was animated. The dark eyes, shining and rapidly moving, never lingered long upon one and the same object. The child was much inclined to bite, and always bit very sharply. Mentally there was pronounced imbecility. In spite of his four years the boy never got so far as to produce any articulate sounds whatever. Even simple words like "papa"
and "mamma" were beyond his ability. His desire for anything was expressed in inarticulate and not specially expressive tones. His sleep was short and light; he often lay whole nights through with open eyes.
He seldom shed tears; his discomfort was manifested chiefly by shrill screaming. He died of pulmonary paralysis at the end of the fourth year.
The autopsy showed that the frontal lobes were surprisingly small, and that there was a partial deficiency of the median longitudinal fissure.
The fissure did not begin till beyond the crown of the head, in the region of the occiput. The anterior half of the cerebrum consequently lacked the division into lateral hemispheres. It had few convolutions also, and the smoothness of its surface was at once obvious. The _corpus callosum_ and the _fornix_ were undeveloped. "The gray cortical layer attained in general only about a third of the normal thickness, and was especially weakly represented in the frontal region." The cerebellum not being stunted, seemed, by the side of the greatly shrunken cerebrum, surprisingly large.
In this case the microcephalous of four years behaves, as far as the development of will is concerned, like the normal boy of four months.
The latter is, in fact, superior to him in _seizing_, while the former in no way manifests any advantage in a psychical point of view.
Two cases of microcephaly have been described by Fletcher Beach (in the "Transactions of the International Medical Congress," London, 1881, iii, 615-626).
E. R. was, in May, 1875, received into his institution at the age of eleven years. She had at the time of her birth a small head, and had at no time manifested much intelligence. She could not stand or walk, but was able to move her arms and legs. Her sight and hearing were normal. She was quiet and obedient, and sat most of the time in her chair. She paid no attention to her bodily needs. She could not speak and had to be fed with a spoon. After six months she became a little more intelligent, made an attempt to speak, and muttered something indistinctly.
She would stretch out her hand when told to give it, and she recognized with a smile her nurse and the physician. Some four months later she would grind her teeth when in a pleasant mood, and would act as if she were shy when spoken to, holding her hand before her eyes. She was fond of her nurse. Thus there was capacity of observation, there were attention, memory, affection, and some power of voluntary movement. She died in January, 1876. Her brain weighed, two days after her death, seven ounces. It is minutely described by the author--but after it had been preserved in alcohol for six years, and it then weighed only two ounces. The author found a number of convolutions not so far developed as in the foetus of six months, according to Gratiolet, and he is of opinion that the cerebellum was further developed after the cerebrum had ceased to grow, so that there was not an arrest of the development but an irregularity. The cerebral hemispheres were asymmetrical, the frontal lobes, corresponding to the psychical performances in the case, being relatively pretty large, while the posterior portion of the third convolution on the left side, the island of Reil, and the operculum were very small, corresponding to the inability to learn to speak. The author connects the slight mobility with the smallness of the parietal and frontal ascending convolutions.
The other case is that of a girl of six years (E. H.), who came to the institution in January, 1879, and died in July of the same year. She could walk about, and she had complete control of her limbs. She was cheerful, easy to be amused, and greatly attached to her nurse. She associated with other children, but could not speak a word. Her hearing was good, her habits bad.
Although she could pick up objects and play with them, it did not occur to her to feed herself. She could take notice and observe, and could remember certain persons. Her brain weighed, two days after death, 20-1/2 ounces, and was, in many respects, as simple as that of an infant; but, in regard to the convolutions, it was far superior to the brain of a monkey--was superior also to that of E. R. The ascending frontal and parietal convolutions were larger, corresponding to the greater mobility. The third frontal convolution and the island of Reil were small on both sides, corresponding to the alalia. The author is of opinion that the ganglionic cells in this brain lacked processes, so that the intercentral connections did not attain development.
A more accurate description of two brains of microcephali is given by Julius Sander in the "Archiv fur Psychiatrie und Nerven-Krankheiten" (i, 299-307; Berlin, 1868), accompanied by good plates. One of these cases is that of which an account is given by Johannes Muller (in the "Medicinische Zeitung des Vereins fur Heilkunde in Preussen," 1836, Nr.
2 und 3).
In the full and detailed treatises concerning microcephali by Karl Vogt ("Archiv fur Anthropologie," ii, 2, 228) and Von Flesch ("Wurzburger Festschrift," ii, 95, 1882) may be found further data in regard to more recent cases.
Many questions of physiological and psychological importance in respect to the capacity of development in cases of imperfectly developed brain are discussed in the "Zeitschrift fur das Idioten-Wesen" by W. Schroter (Dresden) and E. Reichelt (Hubertusburg).
But thus far the methods of microscopical investigation of the brain are still so little developed that we can not yet with certainty establish a causal connection, in individual cases, between the deviations of microcephalic brains from the normal brain and the defects of the psychical functions. The number of brains of microcephali that have been examined with reference to this point is very small, although their scientific value, after thorough-going observation of the possessors of them during life, is immense. For microcephalous children of some years of age are a substitute for imaginary, because never practicable, vivisectory experiments, concerning the connection of body and mind.
To conclude these fragments, let me add here some observations concerning a case of rare interest, that of the microcephalous child, Margarethe Becker (born 1869), very well known in Germany. These observations I recorded on the 9th of July, 1877, in Jena, while the child was left free to do what she pleased.
The girl, eight years of age, born, according to the testimony of her father, with the frontal fontanelle (fonticulus anterior) closed and solid, had a smaller head than a child of one year. The notes follow the same order as that of the observations.
_Time, 8.15 A. M._--The child yawns. She grasps with animation at some human skulls that she sees on a table near her, and directs her look to charts on the walls. She puts her fingers into her nostrils, brushes her apron with both hands, polishes my watch, which I have offered her and she has seized, holds it to one ear, then to one of her father's ears, draws her mouth into a smile, seems to be pleased by the ticking, holds the watch to her father's other ear, then to her own other ear, laughs, and repeats the experiment several times. Her head is very mobile.
The child now folds a bit of paper that I have given her, rolls it up awkwardly, wrinkling her forehead the while, chews up the paper and laughs aloud. Saliva flows from her mouth almost incessantly. Then the child begins to eat a biscuit, giving some of it, however, to her father and the attendant, putting her biscuit to their lips, and this with accuracy at once, whereas in the former case the watch was held at first near the ear, to the temple, and not till afterward to the ear itself.
The girl is very lively; she strikes about her in a lively manner with her hands, sees charts hanging high on the walls, points to them with her finger, throws her head back upon her neck to see them better, and _moves her fingers in the direction of the lines_ of the diagrams. At last weariness seems to come on. The child puts an arm around the neck of her father, sits on his lap, but is more and more restless.
_8.50._--Quiet. To appearance, the child has fallen asleep.
_8.55._--Awake again. The child _sees_ well, _hears_ well, _smells_ well; obeys some few commands, e. g., she gives her hand. But with this her intellectual accomplishments are exhausted. She does not utter a word.
Kollmann, who saw this microcephalous subject in September, 1877, writes, among other things, of her ("Correspondenzblatt der Deutschengesellschaft fur Anthropologie," Nr. 11, S. 132):
"Her gait is tottering, the movements of the head and extremities jerky, not always co-ordinated, hence unsteady, inappropriate and spasmodic; her look is restless, objects are not definitely fixated. The normal functions of her mind are far inferior to those of a child of four years. The eight-year-old Margaret speaks only the word _Mama_; no other articulate sound has been learned by her. She makes known her need of food by plaints, by sounds of weeping, and by distortion of countenance; she laughs when presented with something to eat or with toys. It is only within the last two years that she has become cleanly; since then her appetite has improved. Her nutrition has gained, in comparison with the first years of life, and with it her comprehension also; she helps her mother set the table, and brings plates and knives, when requested to do so, from the place where they are kept. Further, she shows a tender sympathy with her microcephalous brother; she takes bread from the table, goes to her brother's bedside and feeds him, as he is not of himself capable of putting food into his mouth. She shows a very manifest liking for her relatives and a fear of strangers. When taken into the parlor she gave the most decided evidences of fear; being placed upon the table she hid her head in her father's coat, and did not become quiet until her mother took her in her arms. This awakening of mental activity shows that, notwithstanding the extremely small quantity of brain-substance, there exists a certain degree of intellectual development with advancing years. With the fourth year, in the case of M., independent movements began; up to that time she lay, as her five-year-old brother still lies, immovable in body and limbs, with the exception of slight bendings and stretchings."
Richard Pott, who (1879) likewise observed this microcephalous subject, found that she wandered about aimlessly, restlessly, and nimbly, from corner to corner [as if], groping and seeking; yet objects held before her were only momentarily fixated, scarcely holding her attention; often she did not once grasp at them. "The girl goes alone, without tottering or staggering, but her locomotive movements are absolutely without motive, having no end or aim, frequently changing their direction.
Notwithstanding her size, the child gives the impression of the most extreme helplessness." She was fed, but was not indifferent as to food, seeming to prefer sour to sweet. She would come, indeed, when she was called, but seemed not to understand the words spoken to her; she spoke no word herself, but uttered shrill, inarticulate sounds; she felt shame when she was undressed, hiding her face in her sister's lap. The expression of her countenance was harmless, changeable, manifesting no definite psychical processes.